Purpose: To develop and establish expert consensus on essential elements of optimal dietary and exercise referral practices for cancer survivors.
Methods: A four-round modified, Delphi method (face-to-face and electronic). In Round 1, initial statements were drafted based on Cancer Australia’s Principles of Cancer Survivorship and input from key stakeholders (e.g., consumers, allied health, cancer specialists) through a cancer pre-conference workshop. In Round 2, the initial statements were distributed to a stakeholder panel (Round 1 participants) to establish consensus by rating the importance of each statement using a five-point Likert scale. Statements that required significant changes in wording were re-distributed to panel members in Round 3 for voting. Round 4 was for consumers only, requiring them to rate their level of agreement of final statements.
Results: Eighty-two stakeholders participated in Round 1. Response rates for survey Rounds 2 and 3 were 59% (n=54) and 39% (n=36) respectively. Panel members included nurses (22%), dietitians (19%), exercise professionals (16%), and medical practitioners (8%) working in cancer care, and consumers (4%). Mean “importance” rating for all essential element statements was 4.28 or higher (i.e., fairly important, or very important). Round 4’s consumer-only engagement received responses from 58 consumers. Overall, 24 essential elements reached consensus following some revised wording, including the development of three new statements based on panel feedback.
Conclusion: Our developed essential elements of optimal dietary and exercise referral practices can help provide guidance to medical and nursing health professionals relevant to dietary and exercise referral practices. Future research should conduct an implementation intervention and evaluation of these essential elements to optimise dietary and exercise care in cancer survivors.